Blinatumomab

Blincyto® is the trade name for the generic drug blinatumomab. In some cases, health care professionals may use the generic name blinatumomab when referring to the
trade drug name Blincyto®.

Drug Type:

Blinatumomab is a monoclonal antibody. A bispecific T-cell engager (BiTE) antibody. ( For more detail, see "How this drug works" section below).

What Blinatumomab Is Used For:

Blinatumomab is used in the treatment of acute lymphoblastic leukemia (ALL)

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful. This is
called “off-label use”.

How Blinatumomab Is Given:

Blinatumomab is given as an intravenous injection through a vein (IV) as a continuous infusion over 28 days.

Hospitalization is recommended for the first 9 days of cycle 1, and the first 2 days of the second cycle. For all future cycle starts and re-starting (if
treatment is interrupted for more than 4 hours) supervision by a healthcare professional or hospitalization is recommended.

The amount of blinatumomab that you will receive depends on many factors, including your general health or other health problems, and the type of
cancer or condition you have. Your doctor will determine your exact dosage and schedule.

Blinatumomab Side Effects:

Important things to remember about the side effects of blinatumomab:

Most people will not experience all of the blinatumomab side effects listed.

Blinatumomab side effects are often predictable in terms of their onset, duration, and severity.

Blinatumomab side effects are almost always reversible and will go away after therapy is complete.

There is no relationship between the presence or severity of blinatumomab side effects and the effectiveness of the medication.

Blinatumomab side effects may be manageable. There may be options to minimize or prevent them.

The following blinatumomab side effects are common (occurring in greater than 30%) for patients taking blinatumomab:

Neurotoxicity
: In studies, some patients experienced serious neurologic complications, which can occur at any time, even a week or more into the infusion. These
included seizures, confusion, disorientation, difficulty speaking or slurred speech, loss of balance of loss of consciousness. Notify your care team
right away if you develop any neurologic changes.

An uncommon but serious side effect of blinatumomab is the occurrence of cytokine release syndrome. This can happen when the T-cells (part of the body’s
immune system) are activated by the medication when it is first given - causing them to release substances called cytokines. Cytokines are the same
substances released by immune cels that make people feel ill when they have an infection or the flu. This reaction, if left untreated can be very
dangerous. You will be monitored closely for this syndrome. If you experience difficulty breathing or swallowing, wheezing, flushing, hives or rash, fever,
headache, nausea, lightheadedness, shaking or chills, inform your nurse immediately. The infusion may be slowed, or stopped temporarily,

This list includes common and less common side effects for those taking blinatumomab. Bliniatumomab side effects that are very rare -- occurring in
less than about 10 percent of patients -- are not listed here. But you should always inform your health care provider if you experience any unusual
symptoms.

When To Contact Your Doctor or Health Care Provider:

Contact your health care provider immediately and go to the emergency room, day or night, if you should experience any of the following
symptoms:

Blinatumomab Precautions:

Before starting blinatumomab treatment, make sure you tell your doctor about any other medications you are taking (including prescription,
over-the-counter, vitamins, herbal remedies, etc.).

Do not receive any kind of immunization or vaccination without your doctor’s approval while taking blinatumomab.

Inform your health care professional if you are pregnant or may be pregnant prior to starting blinatumomab. Pregnancy category C (use in pregnancy only
when benefit to the mother outweighs risk to the fetus).

For both men and women: Do not conceive a child (get pregnant) while taking blinatumomab. Use effective contraception while taking blinatumomab and for
at least 1 month after the last dose of blinatumomab. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.

Do not breast feed while taking blinatumomab.

Avoid driving, or operating heavy or dangerous machinery during treatment.

Blinatumomab Self-Care Tips:

Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.

You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your
health care provider.

Wash your hands often.

Use an electric razor and a soft toothbrush to minimize bleeding.

Avoid contact sports or activities that could cause injury.

To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.

In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.

Get plenty of rest.

Maintain good nutrition.

If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other
suggestions that are effective in managing such problems.

For flu-like symptoms, keep warm with blankets and drink plenty of liquids. There are medications that can help reduce the discomfort caused by chills.

Acetaminophen or ibuprophen may help relieve discomfort from fever, headache and/or generalized aches and pains. However, be sure to talk with your
doctor before taking it.

Monitoring and Testing While Taking Blinatumomab:

You will be checked regularly by your doctor while you are taking blinotumomab, to monitor side effects and check your response to therapy. Periodic blood
work will be obtained to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be
ordered by your doctor.

How Blinatumomab Works:

Blinatumomab is classified as a monoclonal antibody. Monoclonal antibodies are a type of "targeted" cancer therapy.

Antibodies are an integral part of the body's immune system. Normally, the body creates antibodies in response to an antigen (such as a protein in a germ)
that has entered the body. The antibodies attach to the antigen in order to mark it for destruction by the immune system.

To make anti-cancer monoclonal antibodies in the laboratory, scientists analyze specific antigens on the surface of cancer cells (the targets). Then, using
animal and human proteins, they create a specific antibody that will attach to the target antigen on the cancer cells. When given to the patient, these
monoclonal antibodies will attach to matching antigens like a key fits a lock.

Since monoclonal antibodies target only specific cells, they may cause less toxicity to healthy cells. Monoclonal antibody therapy is usually given only
for cancers in which antigens (and the respective antibodies) have been identified already.

Blinatumomab is a type of monoclonal antibody called a “bispecific T-cell engager” (BiTE) antibody. It works by directing the body’s T-cells (part of the
immune system) to target and bind with the CD19 protein on the surface of B-cell leukemia or lymphoma cells.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained
in this website is meant to be helpful and educational, but is not a substitute for medical advice.

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